Exam 15: The Spine: Management Guidelines

One day following onset of pain and muscle guarding in the low back region, your patient stands with lumbar flexion and a sciatic scoliosis.Repeated flexion tests increase pain into the buttock.Repeated extension done after side gliding increases the pain in the midback and decreases the pain in the buttock.You begin treatment by:

Your patient has nerve root symptoms and has been diagnosed as having degenerative joint disease of the spine.The approach for treating the cause of the symptoms should be:

The vertebral arteries:

Extreme caution should be used when manipulating the spine of patients with rheumatoid arthritis.There is high potential for subluxation of the vertebrae and damage to the spinal cord secondary to:

Your patient presents with a chief complaint of headaches with unknown etiology, beginning last week.During the course of the initial assessment you determine that the source of the headache most probably is not musculoskeletal (a cervical headache).Which of the following indicates that a referral to the patient's physician is appropriate?

All of the following are techniques to increase temporomandibular joint (TMJ) motion except:

All of the following statements are true about functional position (bias) of the spine except:

Your patient complains of facial pain, especially when under tension and when eating.All of the following are appropriate except:

Your patient has acute joint trauma to the cervical spinal facets.Every time she attempts neck motions, there is increased pain and muscle guarding.A possible way to maintain integrity in the contractile units of the muscles is to:

Which of the following is contraindicated for a patient who has undergone L4/L5 laminectomy?

Your patient has signs of an acute lumbar intervertebral disk protrusion.On testing, he experiences decreased symptoms when applying manual traction.To use mechanical traction effectively as part of the treatment plan during the early stages:

Scheuermann's disease:

Treating the soft tissue of the back:

Disk lesions are more common in the 30 year to 45 year age span because:

Which of the following sacroiliac impairments will probably not respond to muscle energy techniques?

All of these are reasons to assess the thoracic spine during evaluation of patients who present with cervical spine dysfunction except:

Your patient has complaints of increasing low back pain during the day.Her job requires repetitive lifting and reaching overhead (25 lb maximum).On examination, you note that on forward bending she has difficulty moving smoothly midrange and that on side bending to the left there is an acute angle in the midlumbar region.Additional tests lead you to hypothesize that she has clinical instability in the midlumbar region.This could be caused by all of the following except:

Following recovery of a posterolateral disk protrusion, your patient will be returning to a job that requires prolonged forward bending and stooping.Your instructions to the patient must include:

All resistive flexion and extension activities and exercises are contraindicated when there is an acute disk lesion because:

Patients with osteoporosis are at high risk for compression fractures of the vertebral bodies.The primary segments of the spine at risk are the thoracolumbar regions.When planning intervention programs for this high-risk population all of the following are appropriate except: